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WITH the theme ‘Drivers towards One Health: strengthening collaboration between physicians and veterinarians’, a conference on One Health held in Madrid earlier this summer was, as Joanne Harries reports on pp 138-139 of this issue, a milestone event, in that it was the first to have been organised jointly by the World Veterinary Association (WVA) and the World Medical Association (WMA), with a view to bringing the two professions together. Held in conjunction with the Spanish medical and veterinary associations, the conference featured a strong programme, and was well attended, attracting 330 delegates from 40 countries around the world. As at previous One Health meetings (see, for example, VR, March 21, 2015, vol 176, p 292) speakers made a compelling case for closer collaboration between doctors and vets in meeting the challenges being presented by, for example, antimicrobial resistance, emerging diseases and global demand for food, as well as in responding to natural disasters. However, it was clear from a show of hands that the number of vets attending the meeting greatly exceeded the number of doctors. No one went so far as to suggest, as was suggested at a meeting in London last year, that, with few notable exceptions, ‘Vets get One Health, doctors don't’ (VR, October 18, 2014, vol 175, p 360). However, it was clear that the veterinary profession continues to take the lead in this area and that more must be done to get more members of the medical profession involved.
Progress continues to be made in this direction, as evidenced by the fact that the joint WVA/WMA meeting in Madrid was held in the first place. Encouragingly, the medical profession was better represented among the students who were present at the meeting, which should bode well for the future. As well as hearing from the presidents of the International Veterinary Students' Association and the International Federation of Medical Students' Associations, the meeting also featured a ceremony in which the winners of a competition for students, ‘The Global One Health Challenge’, were presented with their awards. Sponsored by the Global Alliance for Rabies Control and World Animal Protection, the competition, which attracted 28 entries from 17 countries, aimed to encourage students to work together on One Health rabies prevention projects, to build new relationships and strengthen cooperation. It was won by students from St George's University in Grenada, and a video of their project, which was shown at the conference, was notable for the enthusiasm it conveyed.
In a discussion on how to encourage more interprofessional collaboration, one conference delegate suggested that, in some ways, it was probably too much to hope that the current generation of medical and veterinary professionals would become fully engaged in One Health; much would depend on breaking down educational barriers, and encouraging the next generation to take things forward. There may be some truth in that, but it does not negate the need for action in other areas as well, and the point was made during the conference that efforts to encourage wider uptake of the One Health concept must be made at every level – locally, nationally and internationally. In a world where much will depend on eliminating disciplinary and professional ‘silos’, the point was made, too, that One Health should not just become a discipline in its own right. The aim was not simply to end up with One Health professionals, as that risked creating another silo. What was required was for all professionals to adopt a One Health approach.
Among the many issues discussed at the conference, the Ebola disease outbreak in West Africa was, perhaps, the most obviously topical. One of the problems encountered early in the epidemic, and one which highlights the need to protect health personnel, was that, initially, a high proportion of health workers were affected. This meant that hospital systems quickly collapsed and that, subsequently, procedures had to be reinvented in all types of hospitals. It now looks as if a vaccine against Ebola might soon be available. However, it would clearly have been better if one had been available at the start of the outbreak. As Professor Ab Osterhaus of the Netherlands pointed out during the conference, a good candidate vaccine was available eight years ago and a vaccine could and should have been developed then.
Other presentations at the conference highlighted the need for better disease surveillance at the interface between animals, humans and the environment, and for more sharing of data. The need for better collection of data on antimicrobial resistance in relation to antimicrobial use in people and animals was also emphasised, along with the need to ensure that products are used appropriately. With one speaker noting that, in the USA, there are more households with pets than with children, the strength of the human-companion animal bond was highlighted, as was the contribution of companion animals to human well being.
There is no shortage of issues where a One Health approach is appropriate, and where collaborative, cross-disciplinary action is necessary. The WVA/WMA conference indeed represented a milestone, and more joint conferences are needed. In the meantime, work must continue in getting more members of the medical profession engaged.